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56 terms

Pharm Autonomic Drugs

STUDY
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Bethanechol
Direct cholinomimetic. Postoperative and neurogenic ileus and urinary retention. Activates Bowel and Bladder. Resistent to AChE.
Carbachol
Direct cholinomimetic. Glaucoma, pupillary contraction, and release of intraocular pressure.
Pilocarpine
Direct cholinomimetic. Potent stimulator of sweat, tears, saliva. Pilo like pilus so acts anywhere hair grows (armpits, eyelashes, tongue?). Resistent to AChE.
Methacholine
Direct cholinomimetic. Challenge test for diagnosis of asthma
Neostigmine
Indirect cholinomimetic. Postoperative and neurogenic ileus and urinary retention, MG, reversal of NMJ blockage (post-op). Does not penetrate CNS
Pyridostimgine
Indirect cholinomimetic. MG (long acting); does not penetrate CNS
Edrophonium
Indirect cholinomimetic. Dx of MG (extremely short acting)
Physostigmine
Indirect cholinomimetic. Glaucoma (crosses BBB --> CNS) and atropine OD. Phys for Eyes.
Echothiophage
Indirect cholinomimetic. Glaucoma
Atropine
Muscarinic antagonist. Eye. (mydriasis and cycloplegia = paralysis of ciliary m. so no accomodation)
Homatropine
Muscarinic antagonist. Eye. (mydriasis and cycloplegia = paralysis of ciliary m. so no accomodation)
Tropicamide
Muscarinic antagonist. Eye. (mydriasis and cycloplegia = paralysis of ciliary m. so no accomodation)
Benztropine
Muscarinic antagonist. CNS (Parkinson's dz; PARK my BENZ)
Scopolamine
Muscarinic antagonist. CNS (motion sickness)
Ipratropium
Muscarinic antagonist. Respiratory (Asthma, COPD)
Oxybutynin
Muscarinic antagonist. GU (reduce urgency in mild cystitis and reduce bladder spasms)
Glycopyrrolate
Muscarinic antagonist. GU (reduce urgency in mild cystitis and reduce bladder spasms)
Methscopolamine
Muscarinic antagonist. GI (PUD)
Pirenzepine
Muscarinic antagonist. GI (PUD)
Propantheline
Muscarinic antagonist. GI (PUD)
Atropine and eye
INC pupil dilation, cycloplegia
Atropine and airway
DEC secretions
Atropine and stomach
DEC acid secretion
Atropine and gut
DEC motility
Atropine and bladder
DEC urgency in cystitis
Atropine OD
Sympathetics predominate with no PS balance: Hot as a hare, Dry as a bone, Red as a beet, Blind as a bat, Mad as a hatter
Atropine and possible complications
Angle-closure glaucoma (elderly), urinary retention (BPH), hyperthermia (infants)
Terbutaline
Beta2>beta1 direct agonist. Reduces premature uterine contractions (beta2 agonism reduces uterine tone)
Ritodrine
Beta2 direct agonist. Reduces premature uterine contractions.
Ephedrine
Indirect general agonist. Nasal decongestion, urinary incontinence, hypotension.
Alpha-methyldopa
Centrally acting Alpha-2 agonist. Decreased central adrenergic flow. HTN, esp with renal disease (no decrease in blood flow to kidney)
Selective beta2-agonists
Metaproterenol, albuterol, salmeterol, terbutaline
Mirtazapine
Depression. Tox: sedataion, increase serum cholesterol, inc appetite
Propranolol
Nonselective beta antagonist
Timolol
Nonselective beta antagonist
Nadolol
Nonselective beta antagonist
Pindolol
Nonselective beta antagonist
Labetalol
Nonselective beta antagonist
Sotalol
Nonselective beta antagonist; also K+ blocker (class III)
Acebutolol
beta1>2 antagonist (partial)
Betaxolol
beta1>2 antagonist
Esmolol
beta1>2 antagonist
Atenolol
beta1>2 antagonist
Metoprolol
beta1>2 antagonist
Carvedilol
nonselective beta blocker and alpha-1 blocker
Labetalol
nonselective beta blocker and alpha-1 blocker
Partial beta-agonists
Pindolol, acetutol
Name the direct cholinomimetics.
Bethanechol
Carbachol
Pilocarpine
Methacholine
Name the indirect cholinomimetics (anti-cholinesterases)
Neostigmine
Pyridostigmine
Edrophonium
Physostigmine
Echothiophate
Symptoms of organophosphate poisoning?
PS overload d/t irreversible inhibition of AChE
DUMBBELSS
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Excitation of skel musc and CNS
Lacrimation
Sweating
Salivation
Antidote for organosphosphate poisoning?
Atropine + Pralidoxime (regen of AChE)
Hexamethonium
Nicotinic antagonist. Ganglionic blocker. Prevents vagal reflex responses to changes in blood pressure. SE: orthostatic hypotension, blurred vision, constipation, sexual dysfunction.
Clonidine
Centrally acting alpha2-agonist. Decreased central adrenergic outflow.
alpha-methyldopa.
Centrally acting alpha2-agonist. Decreased central adrenergic outflow.
Name the alpha blockers
Phenoxybenzamine (nonselective)
Phenolamine (nonselective)
Prazosin (alpha1)
Terazosin (alpha1)
Doxazosin (alpha1)
Mirtazapine (alpha2)
Name the drugs that block alpha and bet
Carvedilol
Labetalol